Fire-Dex Blog

Rapid Fire Podcast S2:E1 Addressing Mental Health in the Fire Service


First responders are expected to be calm and level-headed but the stressors faced by those in the fire service can have a cumulative impact on mental health and well-being. Listen in as Andy Starnes and Dena Ali discuss the stigma associated with firefighters seeking help and how peer support resources can be a solution.  

What You Can Expect To Learn   
  • Biggest misconceptions about mental health in firefighters 
  • Addressing feelings vs recycling them 
  • PTSD & peer support resources 
  • Implementing mental health solutions within the fire house 
  • The cause of most firefighter suicides 
  • Individual coping mechanisms 



Dena Ali is a Captain with the Raleigh (NC) Fire Department and previously served as a police officer for five years. She is also the founder and director of North Carolina Peer Support where she helped to develop their statewide curriculum. During her career she earned the NC Office of State Fire Marshal Honor, Courage, and Valor award for her steadfast effort to bring awareness to firefighter mental health. Dena is an advocate of awareness, education, and understanding of mental health disorders and suicidality. She speaks on these topics and is a QPR Suicide Prevention Gatekeeper Instructor. Dena holds a degree from North Carolina State University and an MPA from the University of North Carolina—Pembroke, where her research focused on firefighter suicide. 


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Rapid Fire Episode Transcript:

00:00:04:03 - 00:00:42:16 

Battalion Chief Andy Starnes 

I think tonight's show will probably be just a mutual therapy session for me and you, but hopefully the listeners will get something out of it and we won't charge anybody a co-pay, so we'll be good. Welcome to Rapid Fire podcast hosted by Fire-Dex, dedicated to sharing best practices and lessons learned in hopes of making firefighting a little bit safer. I'm your host battalion chief Andy Starnes, Captain, Dena Ali. I cannot thank you enough for taking time out of your busy schedule. You and I both can appreciate the most valuable thing we have, which is time. 


00:00:43:04 - 00:00:56:09 

Battalion Chief Andy Starnes 

You can make more money, which can make more time. 86,400 seconds. We got to spend them all. So I appreciate you spending a few of those seconds with us, and you want to briefly tell the listeners a little bit about yourself who you are, where you're from. 


00:00:56:22 - 00:01:12:24 

Captain Dena Ali 

So I'm Deena Ali. I work with the City Raleigh Fire Department. I've been there 14 years. I had a short stint in law enforcement before that. Luckily, the television show Rescue Me came on and I realized that women can be firefighters, so that helped me make that transition. 


00:01:13:02 - 00:01:26:01 

Captain Dena Ali 

I don't think anybody pushed me in the servant career. I just always had this passion for two things wanting a career where I was out, not behind an office and then just wanting a noble profession like I had no desire to make lots of money. 


00:01:26:10 - 00:01:44:10 

Captain Dena Ali 

I just thought it was more important to have people doing things that we need. So that's what really drew me to law enforcement and the coolness of it all, I guess. And so the transition to the fire service was because while I was a police officer, I saw what the firefighters did and I felt like they actually showed up on scenes and changed outcomes. Whereas in the law enforcement side, I felt like we showed up on scenes and documented the bad, but rarely had an ability to change the outcome. So I wanted to do something where I felt like I could impact people and change the outcome. 


00:02:00:10 - 00:02:15:04 

Captain Dena Ali 

As you and I have connected over the last several years, mental health has become something just really important to me. I've been really fortunate to get to be connected with people like yourself and others across the state who, you know, are kind of doing the same thing so we can all work together and not make each other's mistakes and keep the ball rolling. 


00:02:17:17 - 00:02:35:21 

Battalion Chief Andy Starnes 

I echo your sentiment of how being connected with people who have the same passion or the same burden. I actually got connected with you when I was tasked or volunteered to write our behavioral health program. I've been following your work and then I sent my mental health mayday as back any talks about to all these people and said help!. I've done peer support, but I've never wrote a program and you were kind enough to look over all my madness in the PowerPoints and go, This is good. I change this. This, this is right. Maybe the statistics not exactly 1% correct. 

And you were very gentle with me, so I appreciate that. So you didn't go wrong, wrong? Wrong. Red ink pen to it all. So that's how I ran into you. So I appreciate that because because of your wise counsel, we have a lot of good material now. Thank you for that. 


00:03:03:09 - 00:03:13:22 

Battalion Chief Andy Starnes 

So help me out with this. You told us a little bit about it, but you said you started in law enforcement, but what year did you actually start? 


00:03:14:23 - 00:03:33:00 

Captain Dena Ali 

So I started law enforcement in 2002 and then in 2007, I don't even know why, but I started volunteering with Garner EMS and the rescue truck. So I got all of my arts classes knocked out and I started actually volunteering and riding the rescue truck. 


00:03:33:18 - 00:03:51:26 

Captain Dena Ali 

And they had a bunch of part timers that were professional firefighters and other cities like Durham, Cary and whatnot. So just hanging out with those guys made me realize how cool the fire service was. So then I fight for the Raleigh Fire Department in late 2007 and got hired started in January 2008. 


00:03:52:08 - 00:04:11:28 

Battalion Chief Andy Starnes 

Since you started in that service field, I think we can all agree that we all have a servant type heart. You wouldn't have been in law enforcement or fire if we didn't want to help people based on that who was the most important or influential person in your life that led you that way or maybe influenced you early on to be more servant minded? Because I always believed this one statement you tell me as you answer this question if this rings true with you, your purpose comes from your passion and your passion with the needs of the world in front of you. 

If you put those together, you find where you're supposed to be. So you tell me who was that person that pointed you on that path and how that affected you and influenced you? 


00:04:39:16 - 00:04:52:26 

Captain Dena Ali 

Honestly, it wasn't just one person. If I just picked one person, I would leave out a lot of others. I was fortunate like and the high school years I had a lot of really influential people took an interest and gave me their time in high school one of my teachers Blank Page, he kind of gave me a chance when I didn't realize it was like a turning point for me. So. I thought I was dumb. Up until recently, I think, but especially when I was in middle and high school because my parents are immigrants and growing up in the house the first five years, I only spoke Arabic. And then when I went to school, I was a little bit behind. And somehow I lost all of my Arabic when I was learning English. But I always seemed to be a year or two behind where everybody else was in school. 


00:05:24:07 - 00:05:39:06 

Captain Dena Ali 

You know, I didn't have the capacity to understand that it wasn't really my fault and I wasn't dumb. I just assumed that I was dumb because I was always behind and I was classified learning disabled. I was put in like a special class for one hour a day in middle school and high school. 

And then in 11th grade, I went to two of my classes. It was an average English and average history. And I looked around and all of the losers were in this class. Everybody that skipped school did drugs getting in trouble, like the classroom was just full of troublemakers. 

Like, at that moment, I was like, Man, I don't want to be here. I don't want to be a part of this. So it's funny. I have no idea why I did the things I did, but I'm proud and happy that I did. 

But I remember I went to Mr. Page and I asked if he'd let me in to his honors class. I had to get special permission, and then I remember him basically saying, Hey, I'm going to give you a chance. 

Don't let me down. So you got me to his honors class. I got into an honors English class and I didn't want to let him down. So my GPA and freshman year was 1.8. By the time I graduated, I was on the Abbey Honorable Roll and I just had never in my life gone home and did homework. 

I literally didn't try because I thought I was dumb. But I think just having Mr. Page give me a chance and me not wanting to let him down. I wanted to do well to let him know that risky took was worth it. 


00:06:40:09 - 00:06:49:00 

Captain Dena Ali 

So, I mean, from high school, from that point forward, I just always wanted to be in law enforcement. I went to college, studied law and justice and got into law enforcement as soon as I could. 


00:06:49:22 - 00:07:05:19 

Battalion Chief Andy Starnes 

I like that. I like the whole concept of changing outcomes and tell them a little bit about how much time and energy and passion and work you've put into to get where you are. I mean, you just talked about how you struggled in school and correct me if I'm wrong, but don't you have a master's degree now? 


00:07:07:21 - 00:07:08:13 

Captain Dena Ali 

I do. I do. 


00:07:09:02 - 00:07:11:16 

Battalion Chief Andy Starnes 

So. So tell me a little bit about that. 


00:07:11:25 - 00:07:28:12 

Captain Dena Ali 

Before you even got on today. We're just talking about how sometimes is it a coincidence or is there a reason that things are put in your path? So when I made Driver, it's the first promotion in Raleigh. It's competitive process and it's the one that eliminates the most people. 

It's arguably one of the most difficult promotions in Raleigh. So when I made it, I did very well. I got promoted. I was just really excited and proud. I felt like, OK, I have the capacity to do well in this career. 


00:07:40:25 - 00:07:57:00 

Captain Dena Ali 

But the transfer sent me to a slow place and we weren't running a lot of calls, so I just kind of wasn't where I wanted to be at the time. But one of my friends who had gotten promoted at the same time as me went to equally slow station on the other side of the city. 

He messaged me one day and was like, Hey, I'm a child graduate school. I'm doing Columbia Southern. I'm getting masters. So with the promotion to Lieutenant, you also filled in as officer. So that was the first time in a few years that I started writing reports, and I felt like I'd forgotten how to write reports. 

I felt like my grammar sucked. So I was bored and I was longing to have something to inspire me. And then I also felt I need to work on writing, so I thought going back to school would be a great idea. 

So I signed up for graduate school and the plan was, I'm just going to see if I can do it like, what's it going to do? one semester, Raleigh will pay for two classes. So I applied to Pembroke, had to take the guy that was really scary and, you know, wrote a letter, had some references and fortunately, I got it in, which was so exciting. So that spring of 2015, I started graduate school, and in the fall, that's when I had that assignment to. It was called action research. So find an area where current practices are not best practices, research and help develop better practices. 


00:08:57:28 - 00:09:12:09 

Captain Dena Ali 

So I reached out to our Safety Officer Hobson, who's a really near and dear friend, a great person, and I asked them, You know, Hey, what's something that I can research that could benefit our fire department? And at the time, I truly thought it was going to be something about RIT, maybe, you know, our nozzles, you know, something tactical and what we do every day.  


00:09:26:09 - 00:09:38:18 

Captain Dena Ali 

And he came back and he said, Can you research firefighter suicide? And this is again, 2015, which isn't that long, almost seven years ago, but in terms of mental health and suicide, it was a long time ago. I googled some articles, printed them and I was reading through him at the firehouse, and I'll keep him turned upside down because I was afraid that anybody see what I was reading. And, you know, wonder what, why or what? But then additionally, at that time, I had gotten moved back to a busier house, but I was assigned with somebody who was a jerk, plain and simple. And the environment was awful. 

And because of some of my early life hood, I had low self-image. His treatment of me made me feel like I deserved it, so I got really depressed. He was extremely rude and hateful towards me, and the guys at our house went along with him. 


00:10:09:15 - 00:10:19:22 

Captain Dena Ali 

Nobody said, Hey, man, what's your deal? I feel like if you, you know, talk about it and walk into any firehouse and say somebody is treating another individual like this everyday, man, I wouldn't let that happen. I'd defend them. But in the moment that it was happening, everybody sided with the bully. He was more well known. He'd been there longer whatnot and even my Capt.  at one point came up to me and said, “Hey, I see what Tim is doing. I see you don't deserve it. There's nothing I can really do. So just keep doing what you're doing.”  At the moment. I understand, my captain, he didn't want to have to do extra work and me, I didn't want to make my captain do extra work. 

We go to work and we try to be squeaky wheels. Sounds like him, OK? But in my head, I felt like he was saying, Hey, you're not worth it to me, don't waste my time. So that kind of added to that low self image. 

And altogether, the end result was depression. It wasn't just that there were other factors. I'm not gonna blame just that one situation, but I found myself extremely depressed. And I remember, like in that time, I would get off work and I would just go home, get back in bed. 

Some days I cry like the exhaustion of putting on this happy face for 24 hours, not letting anybody know that I wasn't happy. And then as soon as the 24 hours were over, I just, you know, everything released got back in bed. 

I was just a different person at time. I was extremely depressed. So ironic when he actually pops and asked me to research firefighter suicide on the inside, I was like, Man, what does he know? Did somebody know something? 


00:11:30:18 - 00:11:46:29 

Captain Dena Ali 

But I'm really grateful for it because all of those feelings I was experiencing the whole time, I had this desperation to be able to talk about it. I was miserable and I wanted help. And instinctually, when we're miserable and want help, we look for somebody that can help us. 


00:11:47:17 - 00:12:05:21 

Captain Dena Ali 

So I wanted somebody to talk to find guidance from. But I was so depressed and I felt like it was ridiculous, and I'm depressed because Tim's being mean to me. And so one of my dominating thoughts was, Man, this is really insignificant compared to all these other people who have real problems. 

This isn't a real problem. You don't need to burden anybody with it. So I kept it myself, and when I got into the research, that was one of the things that was said over and over again is that SS first responders, when we are dealing with depression, when we're dealing with overwhelming stress, a lot of times we don't address it because we think it's insignificant compared to all the all the real problems of the world. But I was just so grateful for that research because a lot of those thoughts, the fear of showing vulnerability, fear, showing weakness, what I'm dealing with is insignificant. 


00:12:39:06 - 00:12:53:27 

Captain Dena Ali 

They were true for me, and that was in the research. And then in the research, it explained that most firefighters that died by suicide. It's not because of the job in the calls. A lot of times it has to do with our inability to ask for help when we need it. 

It has to do with us finding what the research calls maladaptive coping;  drinking, suppressing, you know, numbing. And I recognize I was like, Wow, I'm doing all this, and it just helped me to feel normal, knowing that I was not crazy for feeling like I felt. 


00:13:12:07 - 00:13:24:29 

Captain Dena Ali 

And then, fortunately for me, again, grateful the way life works out. I had a really good friend who think he picked up on something and weekly he would call me and, you know, just check in. And a lot of times I blew him off. 

And then finally, one day when I was just in a really, really bad way and he called, I just told him everything and just cried. And you know, that snot nosed, terrible cry. And this dude never had any training and peer support, had never learned anything about mental health. 

Just a great caring person who has empathy when he responded in a way that I could feel that my pain was felt by him, I could feel the pain in his voice when he responded. He was like partner. 

And that really sucks. I'm so sorry. You don't deserve this. And when he said that just his pain in his voice helped me to realize that I don't deserve this and that I feel awful because of what I'm going through. 

So his empathy, that space man just took that huge weight off my shoulders. And then from that moment forward, I was on this crazy, obsessive mission to continue to learn about firefighter suicide and to continue to learn how to prevent it. 


00:14:20:23 - 00:14:32:20 

Captain Dena Ali 

Because of course, as I did the research, I realized that it's an issue. Suicide is a public health crisis, and the solutions are just not that apparent, and we need we need this work. 


00:14:33:20 - 00:14:50:04 

Battalion Chief Andy Starnes 

I love how you tied all that into this, your testimony is your story. And while a lot of people have careers and some have callings and yours is more of a calling because you don't just have empathy, you have intimate personal ownership. Right?  

And one of the things I actually read today was problems are actually just disguised as opportunities. But very few of us recognize that when we're going through it and like you said, why is this guy giving me this assignment? 

Why is this guy checking on me? There's no coincidences and say what you want. There's people that believe that I don't. I believe that people are put in your life for a reason and they bring you through things if we let them. 


00:15:14:23 - 00:15:31:21 

Battalion Chief Andy Starnes 

But how hypocritical of us that we answer someone's call for not one that we've never met. Don't even know. May not even like we may even die for him in a burning building. But yet me and you, we won't ask for help because of all the different reasons that you know. 

And mostly a lot of in our culture and our stigma because you even said it, you flip the paper over just so they see what you're reading. It's so powerful that in that respect. But what I'd like for you to tie in with that is and this is something you and I are both passionate about is what's probably the biggest misconception people have about your field of expertise. 


00:15:53:29 - 00:16:16:05 

Captain Dena Ali 

And there's two of them. one of them is, Oh man, you know, these people talk about mental health or suicide or whatnot. You know, they're just weak. And we all know that's a huge misconception. But secondly, a big misconception that we have to break is that firefighter suicide firefighter mental health struggles are because of the calls – only. 

That I think we really have to break because I think the best description I found about that is attributing our issues to the calls is just a red herring. It's a convenient scapegoat. But what I know through all the research and through this journey is until you give yourself permission to uncover the true source of your pain and struggle, you'll never go. So as long as you are just going back to saying, “Man, this stuff I see on this calls, it's the work.” Yet you're never digging deep into yourself to understand maybe some of your habits, maybe your early life heard, maybe the way your brains wired, then you'll never heal. 


00:16:57:19 - 00:17:11:21 

Captain Dena Ali 

And I'm a very good example of that because I started this in 2015, I got to teach it at FDIC in 2017, but I didn't even truly understand why I was suffering until about 2019. And it was really crazy. 


00:17:11:21 - 00:17:26:28 

Captain Dena Ali 

It was actually through reading the book. The Body Keeps the Score and there is just 1 sentence in there and one chapter that tied all the pieces together for me. And I realized then that it wasn't because Tim bullied me. It was because as a child, the way I felt about myself, the way my parents had made me feel, I was very down on myself early on in life. It wasn't because of Tim. Yet Tim put me back into a place that started in childhood. 

You know, it took me years to even understand what exactly was going on. And I couldn't just blame Tim because if I didn't address that early stuff, there'd be another Tim in my life that would do the same thing. 

That was just really powerful for me. Over the years, it's been absolutely incredible. I started off. I did all this research and learned so much, and I started sharing my research, which I think is what set me apart from a lot of other people, because everything that I said cited and quoted and it was out of publications, and in fact, I didn't even talk about my personal story. I never admitted anybody where I was because I didn't want anybody think that it was about me presenting myself as like this educated graduate student. And here's the research. 


00:18:21:00 - 00:18:37:22 

Captain Dena Ali 

But as I went down this journey, people would come up to me and they would share their story with me, and they would tell me how what I did impacted them. And I started to feel like a hypocrite because these people were admitting to me that, you know, they struggled and they went through hard times and I was being too proud to let anybody know that I did, too. I slowly started to share my story, and I was grateful for that because as I did that, I would be discredited or they'd think I was a fraud. 

Are you fucking kidding me? You got depressed and suicidal because somebody was mean. Grow up! But unbelievably, after every class, people came up to me and told me that they had experienced exact same thing and I couldn't believe it. 

I couldn't believe how many people were dealing with the exact same thing. So initially, the main thing was just to get it out there that suicide is a problem. It's not just the calls. We're all human. We've got to be able to reach out. 


00:19:15:17 - 00:19:27:06 

Captain Dena Ali 

We have to be able to ask for help. We've got to get ahead of it. Our coping skills really suck. You know, we're taking care of ourselves. And I hate when people do this me and do it again, I’m gonna talk about myself. Me, for example, just learning the practice of mindfulness help me to allow my brain to hit a pause between a thought and a feeling which can lead to a behavior so somebody can give me a look, can make a comment and the old me would immediately think about what they said and then feel a certain way, which is usually negative. And then the behavior may follow that. But now, through a practice of mindfulness, I can hit this pause button between what somebody does and what I allow my thoughts to do. And it's so powerful how something as simple as five minutes a day focusing on your breathing and putting thoughts on pause that daily practice can allow you to control your responses to stimulus. So in the last few years, the main thing that I'm trying to learn more about and share is how do we get people to practice these skills early and learn how to take care of themselves? 


00:20:28:02 - 00:20:41:24 

Captain Dena Ali 

We had a peer support class in Winston-Salem, and something that hasn't really happened as much before is first and foremost. When we went around in the beginning of class and just had everybody introduce themselves and talk about their why. 

Everybody had a different way, but everybody had a why. Some it was divorce that put them in a bad way. Some it was the calls it was. They've run a series of bad calls. Some talked about early life and adversity and issues growing up. 

And then one had cancer. one talked about when he was out with a shoulder injury, the struggles he had in that time. But it was just powerful how everybody had a different story. And I think we all learned from each other that man, it's so much. 

It doesn't matter what it is, though everybody felt the same in that time. The symptomology, the origins were different, but the symptomology was the same. But then what was so cool about that class was the number of people who talked about seeing a counselor and how grateful that they were for doing that and how much help them . And that's what I realized in that moment that that's how we get more people to do. This is having cool people, people that are respected and looked up to that say, Yeah, and I was going through a tough time and I started seeing a counselor and man. I'm grateful I did that and I understand things better. This is how we changed the fire service, more people just sharing their experiences and talking about seeing a counselor.  

There's no fear because back in 2015, if you said that you're seeing a counselor, everybody around you is like, Oh man, that person's broken. I'm glad I'm not that damaged.  

And I told the class I said, I wish that every peer would go see a counselor because you can't truly do peer support well, if you don't know what you're referring people to. And if you don't see what your blind spots might be. I took a few years to have the courage to see a counselor because I was just so afraid of being exposed. But as soon as I did, man, just in that first hour that first visit, I learned so much about myself and had a greater understanding and was able to just drop some defenses. And then over the years of seeing a counselor and being able to talk, I just understand myself better. I can make better decisions with certain things, and then I can just forgive myself for things, which is beautiful. 


00:22:45:24 - 00:23:37:20 

Battalion Chief Andy Starnes 

That's awesome. And I think one of the things that you hit on and I'll quote you is trauma is cumulative, right? So what you talked about, the guy who set you all who was mean to you? You said it well. Well, there's going to be another one like him. Right? And when you went through your journey, you realized it was a deeper issue. And after going through EMDR and seeing a counselor myself, I understand that because they guide you through these rabbit holes and you get down to the end of, then you're like, Wow, I didn't see that coming. I had no idea that was my problem, right? And I completely empathize with where you're coming from because I didn't know where the roots of this problem really was for me, either. And I think that anyone who doesn't go talk to a professional, just peer support, peer supports. Great. You and I both love that. 


00:23:37:20 - 00:24:06:00 

Battalion Chief Andy Starnes 

But just to make you understand how much the whole coincidence thing matters. I had to go to a doctor's appointment today, and my daughter likes to ask me life-changing questions, you know, like you can't answer. And she goes, Daddy, why don't you go to therapy? Why can't you just talk to mom? Great question. And I had to go through why it's necessary to have someone like you, and I know that knows how to ask those right questions and guide you on that path. 


00:24:06:17 - 00:24:23:23 

Battalion Chief Andy Starnes 

All right, because you're really healing yourself once they start guiding you through there. And I think you said it well, but I'd like to ask your expertise on. You've been through quite a journey. And would you agree that this journey helps you in your healing as you share your story? 

And has it made you stronger even through the hard times of being able to stand up and share it and talk about skills because I'm just going to be vulnerable? I often talk about skills that I myself don't have, right? 


00:24:37:08 - 00:24:55:19 

Battalion Chief Andy Starnes 

So I'm trying to empower people with something that I'm I'm still working on, right? So how do you when you're doing these things and helping others through classes through peer support, all the things you do? Has it helped you become stronger in your journey against those things that no matter what we do, there's still always back there? 


00:24:56:02 - 00:25:23:09 

Captain Dena Ali 

Absolutely. one of the biggest pieces is not just seeing like a counselor, but each time we teach a class, we meet people. I'll meet these people who I look up to and I'm like, Wow, this person is so cool. I bet they've never had a problem in their life. And then all of a sudden you find out, Oh, wow, they've had some struggles, too. So I think we all know the power of MeToo and not just like the women's rights Me Too, but the power of me to, when struggling, finding out that you're not alone. 


00:25:23:22 - 00:25:37:11 

Captain Dena Ali 

It's been a bad month in Wake County. We've had to just amazing people in the fire service that are well-known lose their wives and unexpected death of them. No illness that they knew of either one. Different agencies, too. 

And for both, I mean, and everybody around, it's like, how could that happen? There's no. Explanation for it, there's no words for the pain, but it helped me to recognize and understand. Unfortunately, life is a struggle. None of us get through life without struggle. It is pain and that's life. And so how do we just help each other get through that 


00:26:00:13 - 00:26:27:21 

Battalion Chief Andy Starnes 

That's well said. And I love what you said earlier about the skill side when when they ask you to look into something you thought was going to be written or nozzles and all that. The fire service is good as we are and we always be better. We're we're always focused on tactile skills, not the soft stuff and the soft stuff, the head and the heart. If this isn't right right here, that 14 inch journey between the head and the heart. Then none of the other stuff matters, right? 

So with that in mind, with everything you've been through? Help help everybody else out. Because one of the things I love about what we do is I don't believe in doing a PowerPoint and reading things to people. We need to give them something they can use, and I know you have a lot of that. 


00:26:46:27 - 00:27:29:22 

Battalion Chief Andy Starnes 

So help others out. If if you were to give somebody advice, what advice would you give that new firefighter, that person dealing with a bad guy or gal on the station and you being an officer where you are? Because people look up to you, right? Because I think that's three different roles and perspectives that we could have all those people listening right now. We got the rookie who doesn't want to speak up. You got the person who's a senior firefighter just promoted and taken a beating from somebody who's on borderline harassment claim. And then you got someone like me and you who's an officer who people are seeking out answers. We may not have them. So help us out with that, because I think you have some heart knowledge that would really be impactful to people. 


00:27:30:24 - 00:27:55:01 

Captain Dena Ali 

I think the greatest bit of advice that I would give people, no matter where they are in their career, is just give yourself grace and give yourself permission to be unsure and to have anxiety and give yourself permission to have pain and don't vary it away, but actually try to understand it. 

Understand, “OK, what am I feeling and why am I feeling?” It was really actually fascinating for me, a friend of mine Eric Roden, I don't know if you know him, He's, in my opinion, one of the best fire service leaders out there. He's amazing. And so I asked them if he would give me some advice on good leadership book. And he recommended the book, The 15 Commitments of Conscious Leadership and it's a really cool book because the premise of it is that there's this line and we all fall below this line at some point. 

We all fall below the line, whether we do things that are selfish, whether we gossip, whether we get angry or we don't take time to care about others, we all fall below the line. And it's not important that you fall below the line. 

What's important is that you recognize when you've fallen and that you just try to rise above the line. So then it breaks it down into literally the 15 commitments. And I think one of the earliest chapters it's called Feel Your Feelings all the way through. 

And I thought that was so weird. There's a chapter on feelings in a leadership book. How crazy is that? But I recognize how powerful that was because it basically in there explained feelings have a 90 second lifecycle cycle and they're telling you something. 


00:29:09:08 - 00:29:25:12 

Captain Dena Ali 

It's just like a symptom of an illness. Feeling is telling you something now you've broken down, it said. Anger is telling you that you have to leave something behind. Sadness is telling you that there is something to grieve, talked about joy at things to celebrate. 

But what I really thought was powerful was how it separated anger and sadness and then help me understand like being angry isn't a bad thing. It's OK to be angry, but you have to explore, OK, why am I angry? 

What am I to leave behind? Feelings have a 92nd life cycle, and you truly have to notice where you feel them. Allow yourself to feel them. And then if you want to move through them, you make a noise. 

Shake talked about animals. If you pay attention to an animal in the wild, if they're scared, they'll do something. They'll shake and then they're right back to normal. They reset. Well, humans can do the same thing. However, for humans, we don't allow that full cycle. 


00:30:04:03 - 00:30:56:04 

Captain Dena Ali 

We suppress it and we bury it. So with that said, I think the best advice is if you are angry, if you're sad, you're not wrong. Because I know from my experience over the years, I've had friends who were like, Man, I don't know why I'm angry. I must be an angry person. I need to learn how to control my anger rather than maybe it's not you. Maybe there's something that's causing you to be angry that needs to be addressed. And I think that that's where we, we struggle the most is we don't understand what needs to be addressed and we never address it . Even in that book, it talked about how we recycle feelings because they never get addressed so they could just get recycled. And just venting about them isn't enough because you're not doing anything, you're just recycling them. So the best advice is, you know, allow yourself to feel, know it's OK to feel it's OK not to be OK, but do something about it. OK. 


00:30:59:24 - 00:31:38:14 

Battalion Chief Andy Starnes 

Well, and that being said, though, getting firefighters to experience the fact that they're human beings and they need to feel that's a difficult fight with a lot of us, right? Because we put on a different persona, we go to work like you even said, I put on this face that wasn't genuine, and then I went home. And you know, where my problems showed up was when I went home. I took that face off that persona, and that's when I would snap, right? That's where everything was real. So with that being said? You and I just talked about the person feeling things, and it's OK to feel if I'm feeling these things. 


00:31:39:19 - 00:31:57:26 

Battalion Chief Andy Starnes 

How important is it to have someone, not a councilor, but a trusted peer like that person who reached out to you to talk to? Is that if I was to rank that person in like dollars, gold, platinum, priceless, where would you put that person? 


00:31:58:29 - 00:32:17:02 

Captain Dena Ali 

Well, I know where we're leading with this, and I recognize that person is really important. But something else I know is. Not always necessary for that person, right? Sometimes it's just journaling can help. But what's platinum is the ability to process and understand. 


00:32:17:09 - 00:32:29:02 

Captain Dena Ali 

And it's fascinating because in our peer support class and the active listening section, I had this 32nd cut that I took from Chicago Med, where Dr. Charles is talking to this kid who's sitting on a ledge and he's trying to get this kid to come off the ledge. 

And one thing he says is not wanting to feel these bad feelings is the most normal thing in the world. Nobody wants to feel bad feelings, but it's important to understand what you're feeling and understand why it's happening. 

So maybe if these feelings come back again, you'll understand them better. And I thought it was so powerful how we can just kind of lock ourselves down and start ruminating and going into the wrong direction. And sometimes it just it does take somebody else to bring you back to reality and to help you just understand what's happening and peer support, these people come to the two-day class thinking they're going to learn how to solve problems and give solutions, and they don't realize 80% of what they're learning to do is actively listen and maybe summarize, restate emotionally label and the power of somebody giving you their time, their appreciation, their attention, and then just restating, “So if I'm understanding correctly this, this and this is sounds like you're really disappointed because of this this and this. And then for the person that gets it off their chest, it's like, “yes!” really hard for them to fathom how powerful that is and how helpful it is. 

And it just reminds me of when Brian did that for me. He didn't give me any solutions. You didn't solve any problems. He literally just spared my pain and allowed me to understand that it was OK. 


00:33:50:24 - 00:34:00:22 

Battalion Chief Andy Starnes 

Amen to that! No one I've learned in marriage. My wife doesn't want me to fix the problem. She wants me to listen and she'll fix it herself. She just wants me to be present for it. So. 


00:34:02:01 - 00:34:11:27 

Captain Dena Ali 

Throughout the journey, too, we've had several people that were a part of the team or several people who were associated with the team who blatantly say, and I'll also ask his permission to say, throw his name out there, but he was in our class this week. He was also in the same class almost four years ago, so he took it again for a second time, but in between that time, he lost a brother to suicide and he lost another family member. So he had a rough go and it all happened in a short period of time. So I'll never forget the first time he took the class. 

He straight up said - it was hilarious- He was like, I want to know what this is all about. I like helping people. And I don't know what it's like. The struggles. I've never had these problems. I just want to know more so I can help people. And he seemed like he was being honest. And, you know, he straight up said, like, I don't know, I've never had to deal with any of this stuff. I've never had to deal with any mental health. And then when he took the class this week, he kind of laughed at himself for that. 

And he talked about his journey since that point and how now he gets it. And he's not the only one. 


00:34:57:22 - 00:35:12:05 

Battalion Chief Andy Starnes 

I've had more firefighters call me and say, I don't believe in this PTSD or depression, and then later it hits them. And one of the things a friend of mine, Mike Garen and I quote him all the time he goes, Andy, where members of clubs nobody wants to be a member of. 


00:35:13:02 - 00:35:25:16 

Battalion Chief Andy Starnes 

And the first question I asked our peer support team when we started was how many of you had any formal training? None of them raised and I said, how many have been through something bad? They'll raise your hand and say, how many you want to help people right now. 


00:35:25:18 - 00:35:42:26 

Battalion Chief Andy Starnes 

Answer, Congratulations, you're her! You're hired because they had compassion, which means to suffer with the need to help others. And they had been through something bad, so they were intimately connected to it. That guy you talked about at first, he was better than most because he wanted to understand. Now, as you said, he's got a why. He's got something painful that's that sticks with him, that says, I want as you learn, I want to help others. I want to prevent this from happening, but I want you to help me with something that this is you're going to help me right now. 


00:36:01:13 - 00:36:12:19 

Battalion Chief Andy Starnes 

OK, so you've helped me a lot, but let's talk. But we talked about the person, we talked about your journey and how it's helped. You helped others and it's OK to feel and what what advice you give them. 


00:36:13:06 - 00:36:30:18 

Battalion Chief Andy Starnes 

Let's switch gears and say, All right. Right now, if you and I had a blank check, we could go to every fire department and we could prescribe the solution. What could fire departments do to address, as you said in the beginning, this is a big deal. The mental health challenges that first responders face because in my opinion and your big research person, we're going to see a higher suicide rate and depression and behavioral health issues, collateral damage in the next ten years from this and it's going to be massive, it's going to be covered and it's going to show up in big ways. What could we do if you and I were philanthropists and we had 1,000,000,000 dollar checkbook and we could go and prescribe solutions and if they'd actually listen to what advice would you give a fire department that was willing to listen to implement things to help their firefighters? What would you do? 


00:37:09:26 - 00:37:21:11 

Captain Dena Ali 

The things that I've noticed that have the greatest value is, first of all, just leaders that can model the vulnerability that they want to see in their people. Mm-Hmm. You want your people to ask for help when they need help, you have to show them that you're going to do that and maybe you've done that. I heard a story of a fire chief who every Thursday at 2:00 had on his calendar going to see his therapist, so he may not even have been doing that, but he was letting all his people know that seeing a therapist is OK. Let's educate our leaders on prevalence of mental health. What it is. And then that they can stop being superheroes. They can drop their capes and just model the vulnerability be an ear for their people. Company Officer Training Battalion Chief Training Company option above. 


00:37:54:14 - 00:38:41:19 

Captain Dena Ali 

They need to have a good awareness and understanding about resources, and especially just knowing that if you have someone comes to work and comes to you and tells you that they're struggling and they're suffering and they're going through a lot that you don't have to have any training to be able to be a decent human being and help them. I hear so many times these these leaders, yeah, that wasn't my, you know, out of my pay range. I'm not trained for it. So I immediately referred them and I'm like, You have no idea how much damage it does when you shut somebody down and you tell them, I can't handle this, that now that amplifies them feeling like they're screwed up. Where as if you could have actually given them your time, you could have made a huge difference so that company officer and above training, I think, is very important. But then secondly, on the opposite end of the spectrum. 


00:38:42:18 - 00:38:54:25 

Captain Dena Ali 

We need to learn how to get ahead of this. And I heard this awesome analogy. This lady was talking, comparing mental health to physical health, and she talked about diabetic who just is out of whack, out of control to the point where they end up in ICU. 

And she's like, Yes, once you're in ICU, we can help you. We can get you right. We can give you all this time. Attention is we really expensive? It may take some time, but we can get you right. 

But man, I would have much rather changed your diet. And added, some exercise changed your habits, so you never ended up in ICU. And then you compare it to mental health. Yeah, when you get in crisis and you break, if you end up in intensive care, we can help you get back to normal. 

But wow, wouldn't you like to be able to prevent yourself from getting into that point? So Jade Betancourt in the Astral Fire Department, they started that a resilient mine's frontline resilience program. I know Charlotte last several academies as institute it for their recruits. 


00:39:39:17 - 00:39:56:02 

Captain Dena Ali 

So Jay Bettencourt in the Asheville Fire Department, started that a Resilient Minds Frontline Resilience Program. I know Charlotte last several academies as institute it for their recruits. 

And I got to take their pilot program and I've got to hear them speak and share data, and they're showing that, you know, the recruits are indicating what a difference it's made. And I've looked at the research from the military and the military found that when soldiers who were in basic training received that eight-week mindfulness-based stress reduction training, they had substantially lower rates of PTSD, anxiety, depression and then plain and simple. We all know - or we don't all know, we need to all know - that mindfulness could be one of our greatest superpowers. It's free, anybody can do it, and it's so critically important to train yourself to have that practice of being able to choose your response to a stimulus. Without a practice of mindfulness, it's very easy to get stuck in negative habit loops. 


00:40:27:04 - 00:40:50:00 

Captain Dena Ali 

But with that habit, we can truly protect yourself from a lot of really damaging things. So we have an unlimited budget. I would make sure that every firefighter attended and was trained in mindfulness and not just trained in it, but trained by somebody like Jay Betancourt, who was an incredible job. Who can actually help them understand the importance and ensure that they are learning it well. 


00:40:50:10 - 00:41:35:24 

Battalion Chief Andy Starnes 

So I have a big question for you to spend the last five or ten minutes talking about. So we talked about how you got into this. Your heart, your the hurt, how divine intervention, if you will, people putting your lives and and your educational journey and where you are with that and how you've helped others and how to help people understand it's OK to feel. And we've got to the part about this is a big deal for America to recognize that we need to do a better job of being proactive with our training and firefighters. And you started in the inception from recruit all the way to retiree. This needs to be in there, whatever they choose. But I like the mindfulness. I like resiliency programs. I love all that because it teaches us to cope, right? 


00:41:37:00 - 00:42:08:18 

Battalion Chief Andy Starnes 

Let's talk about that firefighter right now who's at a department that has nothing. They don't have anything but an ERP program, and, you know, you and I probably feel the same way about most ERP programs. What can we teach them? What can knowledge and experience can you share about? You talked about mindfulness, but healthy coping mechanisms use the phrase What was it? Maladaptive? Right? So unhealthy coping mechanisms. We already do a lot of that. The drinking and the other things to mask things, right? 

So we as a service are sleep deprived. We have high stress jobs. Most of us work at least two jobs, right? We have family commitments. We don't know the word no. We're way out of balance. All of those things, right? 

We don't eat right. We don't exercise. But you can't outperform a bad diet. I'm living proof of that. 


00:42:32:15 - 00:42:51:21 

Battalion Chief Andy Starnes 

Yeah. Well, you know, I'm my wife and I are straighten that out. We're working on it. But what can we do for that firefighter to teach them right now? How can you cope? What are some things they can do to cope day to day, moment by moment to get through these things they're dealing with? 

Give them some tactics, if you will, of managing that working fire inside of their life, in their head or heart. 


00:42:59:13 - 00:43:12:22 

Captain Dena Ali 

We recently had this traumatic call, but I recognized that it wasn't at the level that they were going to request a debriefing. It was just we saw something really bad and I could even look at the responders and tell me, and this is going to be one that they don't forget. 


00:43:13:11 - 00:43:30:08 

Captain Dena Ali 

And when I step back, I was like, Man, we haven't really prepared people for the simple day to day things that will impact them. They know about EAP. They know about debriefings. All the big stuff. But what about the day to day things that can help us manage and stay healthy? 


00:43:30:16 - 00:43:48:26 

Captain Dena Ali 

So there are a lot of really simple things that we can do that are actually incredibly important and more important than those big things that we're always expressing. So first and foremost, you have to just process it. And we all process things differently. 


00:43:49:13 - 00:44:04:26 

Captain Dena Ali 

Some people talk about it. Some people journal. Figure out what works for you and make sure you do it. We know that talking to other people - Authentic, meaningful connection - where the person you're talking to, you don't have to withhold or fear saying the wrong thing. 

You can actually talk about what's on your mind. So important. Secondly, journaling. That's something that a lot of people don't realize is really powerful and really useful. There's been research and studies done across several populations, from college students to prisoners to veterans to even people in rest homes. 


00:44:23:20 - 00:44:41:10 

Captain Dena Ali 

And they found that journaling about negative events is an incredible way to process them. And even within, like the college setting, they found that the students that journal about negative events had less visits for physical ailments, and it was really fascinating to learn how powerful journaling is a lot of people are intimidated by it, or they think they have to write a lot. So they have to share over and over again as you can just be one sentence. That's it. Just one sentence, but a practice of journaling. If you're having negative thoughts or you just need to get something out, write it down. 


00:44:53:19 - 00:45:11:21 

Captain Dena Ali 

Something else that's so easy and so powerful is gratitude. And it's so easy to forget to share gratitude. But if you have a daily practice of gratitude where you wake up and this is what I started doing, instead of waking up and moving quickly, I started to wake up and just sit for a minute. Relax, don't look at a phone. Don't start getting ready, but just kind of settle. And then just what are the three things I'm grateful for today? 

So no matter how bad yesterday was, I'm starting my day off with three things that I'm grateful for. And what I found is if and when I do that, when negative things happen during the day or when sad things happen, or things that we can't explain, that practice of gratitude helps to remind me that it's not all black, it's not all dim, it's not all dark that there's something to be grateful for. So talking to people, journaling gratitude, and then I'm so grateful that you hit on sleep. We have created this culture where we think that people who sleep are lazy or people who sleep or not living their fullest potential. 


00:46:03:00 - 00:46:14:16 

Captain Dena Ali 

But my research has taught me that the greatest thing that can negatively impact our lives is a lack of sleep and the greatest thing that can protect our minds and our bodies is sleep. 

I mean, everything from reducing cancer to reducing Alzheimer's. Everything! Dr. Walker said that every single mental health disorder has a link to poor sleep. And if you think about things like PTSD in that R.E.M. sleep, that is where your mind can actually process and store memories. You mentioned EMDR, EMDR is mimicking R.E.M. 

That's what's happening in R.E.M. sleep. Dr. Banjoko calls it inbuilt therapy. So the people who take Ambien or drink alcohol or have undiagnosed and untreated sleep apnea, they're never allowing themselves to get RDM sleep. They're creating a really negative environment in their brain, a place that could naturally heal them. So I would coach and counsel and hope that people just take sleep seriously. 


00:46:58:29 - 00:47:14:08 

Captain Dena Ali 

And if you are sleeping really poorly and you have a hard time with sleep. Sleep is like every other habit. You really have to have a routine for it to kick in. So for me, every night before work, I make sure that I shut things down about an hour before I want to be asleep. And I make sure that I'm asleep by 10:00pm and I get eight hours because I'm at a busy firehouse. 


00:47:26:03 - 00:47:35:20 

Captain Dena Ali 

I want to get that eight hours of sleep, something I didn't understand it, it realized, was if you have distractions in your sleeping area, it's going to be harder to sleep because your body doesn't recognize it as a place for sleep. 

So things like my cube at the firehouse, I don't watch TV, I don't hang out, I don't read, I don't do anything. I just sleep there and I'm able to fall asleep easier. The same thing with my room. 

The only difference is I have a Kindle, and I'll read the Kindle for about 30 minutes before bed, and that usually puts me out. So, yeah, those are free, easy things that anybody can start doing tomorrow. 


00:47:55:26 - 00:48:10:24 

Battalion Chief Andy Starnes 

I'm glad you mentioned the purpose of understanding how powerful sleep is because I'm intimately familiar with that. I was diagnosed with sleep apnea about three years ago, and ever since then, you know, having the dreaded CPAP machine that everybody hates. 

I packed that thing before I packed my toothbrush because I sleep so much better. As my wife told me when I chose a battalion, she chose it for me. She said, Can I have some say so in your station assignment? 

I said, Why? She said, Because you've had it your way for 21 years. You can be busy at work or you can be busy at home. I can't take both. So off to the airport, I go and I sleep most nights and my behavior is quite different. 

You know, I'm a 46 year old husband, coming home, being a dad and running a business. I need sleep, and I completely get it, because when I didn't get sleep, I was a different person. You taught me when I've put together a program, every one of those behavioral health issues was linked to sleep deprivation, sleep disruption. Huge! 


00:48:58:01 - 00:49:29:17 

Battalion Chief Andy Starnes 

And think about these guys and gals who spent a 25-30 year career being wide open at a busy, busy firehouse. And then they just retire. That's actually bad to just slam on the brakes, are that right? I've actually had retirees come in and talk about how they think they had PTSD because they're finally getting some sleep and having nightmares, terrible nightmares. So I'm glad you hit on that, because I think we tend to just like in the beginning where you said, Oh, you know, we should talk about this, I shouldn't be upset or someone's picking on my feelings. 


00:49:30:06 - 00:49:44:12 

Battalion Chief Andy Starnes 

We also think that we should be able to go 18-20 hours and sleep for two hours and get up to be good. Right? It doesn't work that way. You're a big fan. I'm sure Dr. Grossman's work and reading about what he talks about in that and how efficiency goes down. So all the things we talked about tonight, I would ask you to give to the listeners this final statement. If you were going to try to be the best first responder, firefighter, police officer, whatever you were going to be, would you tell them no matter what skill set you have? 

If you don't get this training, you're going to cut your career short. Would you agree with that? 


00:50:10:01 - 00:50:29:02 

Captain Dena Ali 

Oh, yeah, yeah. one of the things I've seen and I've paid attention to is even like going back to talking about sleep, all those people who are on those busy trucks and ran nonstop and stayed busy. If you pay attention to the way people age in the fire service, you could tell the ones that get sleep versus the ones that don't get sleep because you've got 40 year olds that look 60. Right? And then you've got 60 year olds that look 30. I bet mindfulness training. None of us know that we should practice mindfulness unless somebody shows us. 

A lot of us just don't recognize that it's OK not to be OK, and it's OK to talk to people. So the training doesn't have to be complex. It just has to come from a place that allows that person to know that it's true that they care. 

We can have training all day long. That's important. But if the person delivering it doesn't show that it matters and that they care, then the person absorbing it's not going to care. And that's why I try not to go too much into my story. 

But I know it's so important to show that there's more to this than research. I've experienced this and this is what's helped me, and I hope it can help you. 


00:51:16:10 - 00:51:27:14 

Battalion Chief Andy Starnes 

Well, and I appreciate your time and everything you share with us tonight, can you tell everybody that they want to connect with you or find more resources that you have where they could find you, where they can find that stuff? 


00:51:27:14 - 00:51:29:00 

Battalion Chief Andy Starnes 

Can you point them to that for us? 


00:51:29:27 - 00:51:43:29 

Captain Dena Ali 

Email me. That's probably one of the best ways. On LinkedIn. I've posted every publication I've written. I think that's the only place I know that I could post every publication publicly, so I could be found by my first and last name very easily. I don't have anything that's private, which I probably should. 


00:51:44:20 - 00:52:13:15 

Battalion Chief Andy Starnes 

And I can't thank you enough. I know you're extremely busy and you have 1,000,000 things going on. But you said at the beginning you were so thankful that that one guy reached out to you. And what I think people fail to realize who are on the fence of being on a guest or a show like this, everybody has something to offer and we all are the pieces of the puzzle. And you just shared a very important piece of a puzzle that someone hopefully hears that will help them. And that piece will complete it for them, and maybe they'll go get the help. 


00:52:13:15 - 00:52:24:05 

Battalion Chief Andy Starnes 

Maybe they'll start getting the training, whatever it is. We can only hope that that happens. And you and I may not see that on this side of the world, but one day I think we're going to get to see the fruits of those labor. 


00:52:24:05 - 00:52:35:18 

Battalion Chief Andy Starnes 

So. From me to you, I really appreciate and grateful for what you're doing. Don't grow weary in doing good and thanks for your time. We look forward to seeing where your next journey takes you. Thanks. 


00:52:36:11 - 00:52:43:08 

Captain Dena Ali 

It's an honor to be asked to be on the show because there's a lot of people out there, and it means a lot that you consider what's in this head of value. So thank you. 


00:52:43:17 - 00:52:57:19 

Battalion Chief Andy Starnes 

We appreciate everyone taking their time to listen and hopefully through this that someone will find the knowledge or the information that they need. And as you have learned, they'll go out and seek out more information and make sure you reach out to Dina and check out the work they're doing. 


00:52:57:28 - 00:53:08:16 

Battalion Chief Andy Starnes 

If you're interested in learning how to start your own program, I know no one better to talk to you than her. Thanks again. Everyone have a good night and we greatly appreciate you listening. 


00:53:08:16 - 00:53:13:15 

Battalion Chief Andy Starnes 

Thank you for joining us on this episode of Rapid Fire, if you enjoyed today's topic and want to learn more. 


00:53:13:20 - 00:53:27:08 

Battalion Chief Andy Starnes 

Head over to fire Dexcom Flash Rapid Fire And as a token of our appreciation to all of you tuning in, we offer 10% off our e-store. When you use coupon code rapid fire, all caps at fire, Dexcom flash shock. 


00:53:27:20 - 00:53:31:15 

Battalion Chief Andy Starnes 

Tune in next time as we continue our efforts to make firefighting a little bit safer. 




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